Ankylosing spondylitis
Incidental findings Iritis, distal arthritis
+ve signs Question mark posture: loss of lumbar lordosis, fixed kyphosis, compensated extension cervical spine. Protruberant abdomen.
Differential diagnosis Ankylosing spondylitis
Function Ability to turn head
Tests L spine XR – Erosion,sclerosis sacroiliac joints / syndesmophytes / bamboo spine
HLA-B27
Extensions

  • Ask to turn head – whole body turns as block
  • Chest for apical fibrosis
  • Heart for aortic reguritation
  • Stand with heels, hips, occiput against wall. Shober’s – marks made 5cm above and below sacral dimples, patient bends forwards
Notes

  • Other features: achilles tendinitis, plantar fasciitis